TUESDAY, May 21 (HealthDay News) -- Swollen tonsils and adenoids are a major cause of sleep apnea in children, and while removing them did not improve attention, memory or learning for these kids, it did help them with sleep, behavior and quality of life, a new study finds.

Sleep apnea is a condition that causes abnormal pauses in breathing during sleep.

"There was a greater improvement in sleep with the surgery, and those improvements were likely responsible for the improvement in daytime functioning, energy levels and behavior," said lead researcher Dr. Susan Redline, a professor of sleep medicine at Harvard Medical School.

Earlier studies have found that sleep apnea is associated with mental problems, including attention-deficit/hyperactivity disorder (ADHD), Redline noted. Swollen tonsils and adenoids block a person's airways and restrict breathing, which is why they are the major cause of sleep apnea in children, Redline explained.

Sleep apnea causes a drop in oxygen levels, which some experts have thought may have a harmful effect on memory and learning, she said. "We thought that by opening the airway we might be able to see greater improvement in these areas," Redline explained.

Removing the tonsils and adenoids, in a procedure called an adenotonsillectomy, however, did not change memory and learning, she noted.

"There have been parents who are worried about their children snoring and sleep apnea, and have felt nervous that if they didn't rapidly do the surgery they might be exposing their child to poor school performance," Redline said.

This study, however, suggests that if a parent wanted to choose a more conservative approach of watchful waiting, there is no mental decline, she stated.

"Children who are having behavior problems, are feeling sleepy, are waking up un-refreshed in the morning and dragging during the day are much more likely to get a benefit from early surgery," Redline said.

The report was published online May 21 in the New England Journal of Medicine, to coincide with its planned presentation at the American Thoracic Society annual meeting in Philadelphia.

"This is another validation of adenotonsillectomy for the treatment of sleep apnea in children," said Dr. Sandeep Dave, an otolaryngologist at Miami Children's Hospital. "We advise and recommend surgery for sleep apnea."

As for whether mental function is harmed by sleep apnea, "I think the verdict is still out whether or not there are changes in attention-deficit [ADHD]," Dave said.

For the study, 464 children aged 5 to 7 years were randomly assigned to have their tonsils and adenoids removed or to "watchful waiting with supportive care."

Almost half of the children in the study were obese or overweight, the researchers noted. Sleep apnea is more prevalent among obese or overweight kids.

To see whether the surgery improved learning and memory, the children were examined using a test called the Developmental Neuropsychological Assessment.

The researchers found no significant difference in these test results between the children who had surgery and those who didn't.

Children who had surgery, however, showed significant improvements in behavior, sleepiness, executive functioning and quality of life, compared with children in the watchful waiting group, the study authors noted.

Parents were asked to rate how well their child kept up with tasks, got along with other children and planned ahead, and whether they had angry outbursts or mood changes, worried frequently or had trouble sleeping.

These results were confirmed by the children's teachers as well, the researchers added.

Adenotonsillectomy is the primary treatment for sleep apnea in children. Over half a million U.S. children have the surgery each year, according to the researchers.

More information

For more information on sleep apnea in children, visit the American Sleep Apnea Association.

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TUESDAY, May 21 (HealthDay News) -- Urban elementary school children with poorly controlled asthma are likely to experience sleep problems and suffer academically, new research indicates.

"In our sample of urban schoolchildren, aged seven to nine, we found that compromised lung function corresponded with both poor sleep efficiency and impaired academic performance," said study author Daphne Koinis-Mitchell, an associate professor of psychiatry and human behavior at Brown University's Alpert Medical School in Providence, R.I.

Koinis-Mitchell, who is also an associate professor of pediatrics, is scheduled to present her findings Tuesday at the American Thoracic Society annual meeting in Philadelphia.

The findings stem from an analysis involving 170 pairs of white, black and Hispanic children and their fathers living in the Providence area.

The children's asthma symptoms were monitored over three-month periods, and the children and their parents were asked to keep a health diary as well.

Questionnaires were also completed to gauge the degree to which asthmatic symptoms were kept under control. Sleep quality was also monitored and quantified.

The result: Children with poorly controlled asthma fared worse at school, according to their teachers. "Carelessness" regarding school work was also linked to poorer sleep, as was difficulty in staying awake while in class.

"Urban and ethnic minority children are at an increased risk for high levels of asthma morbidity and frequent health care utilization due to asthma. Given the high level of asthma burden in these groups, and the effects that urban poverty can have on the home environments and the neighborhoods of urban families, it is important to identify modifiable targets for intervention," Koinis-Mitchell said in a news release from the thoracic society.

Efforts aimed at improving asthma control and sleep quality may help to boost academic performance in this vulnerable population, she added. "In addition, school-level interventions can involve identifying children with asthma who miss school often, appear sleepy and inattentive during class or who have difficulty with school work. Working collaboratively with the school system, as well as the child and family, may ultimately enhance the child's asthma control," she said.

Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

More information

For more on asthma and children, visit the American Lung Association.

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TUESDAY, May 21 (HealthDay News) -- The risk of sudden infant death syndrome (SIDS) is five times higher when parents sleep with their infant, a new study finds.

British researchers noted that bed-sharing increases the risk for SIDS even if parents do not drink, use illegal drugs or smoke. They advised that rates of SIDS, which is a major cause of infant death in developed countries, would drop dramatically if parents did not sleep with their babies.

In the United States, all parents are advised to not sleep with infants less than 3 months old. However, in England only certain parents, such as those who smoke, drink or use drugs, are advised to do the same. Based on their findings, the researchers said a stronger stance against bed-sharing for infants is needed in that country.

The study, led by Robert Carpenter, a professor at the London School of Hygiene and Tropical Medicine, involved data on 1,472 SIDS cases and 4,679 "controls" published in five different sets of data from the United Kingdom, Europe and Australasia.

"Eighty-eight percent of the deaths that occurred while bed-sharing would probably not have occurred had the baby been placed on its back in a cot by the parents' bed," the study authors wrote in a school news release.

The researchers added that even among very low-risk breast-fed babies, 81 percent of SIDS deaths in infants under the age of 3 months could have been prevented by not co-sleeping. In cases where neither parent smoked, the baby was breast-fed and the mother did not drink or take drugs, the risk for SIDS was still five times higher than if the baby slept in a crib next to the parents' bed. The study authors pointed out that the parents of 22 percent of the infants who died from SIDS had been sleeping with their child at the time of death.

The investigators pointed out the risk for SIDS drops as babies get older. Still, they noted, the risk was much higher if either parent smoked, or if the mother had at least two drinks within 24 hours or had used illegal drugs, such as marijuana, at any time since the baby was born.

Over the past decade, there has been a significant increase in co-sleeping; the study authors estimated that about half of SIDS cases occur while co-sleeping.

"We do not suggest that babies should not be brought into the parent's bed for comfort and feeding," the researchers wrote. "This has been investigated in previous studies and has not been found to be a risk factor, provided the infant is returned to his or her own cot for sleep."

The study was published in the current online edition of the journal BMJ Open.

More information

The U.S. Centers for Disease Control and Prevention has more about SIDS.

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MONDAY, May 20 (HealthDay News) -- Young drivers who get behind the wheel while drowsy run a higher risk of getting into car crashes, but Australian researchers have found that not catching up on missed sleep on weekends puts them in even greater danger of having an accident at night.

"This is another challenge to adolescents that comes with lack of sleep," said Dr. Flaura Winston, co-scientific director and founder of the Center for Injury Research and Prevention at Children's Hospital of Philadelphia.

"You have to be ready, body and mind, to drive," she said. "If you are exhausted, you are neither ready body nor mind."

In tackling this challenge, both parents and the community have roles to play, said Winston, who was not involved with the study.

"This is a safety concern," she said. "If the teen doesn't get enough sleep, then they are at increased risk for crashes, so parents need to step in."

Parents should see their role as one that helps their teenager stay safe without being controlling, Winston explained. They can encourage their children to get more sleep, and provide rides at night to ensure that their teens are not driving exhausted.

One of the more positive things parents can do is let their teen sleep late on the weekends, Winston noted. "Teens need their catch-up sleep," she said. "They do need to sleep late on the weekends."

There are also social factors that limit teens' sleep. For example, many high schools start classes very early, cutting into students' sleep time, Winston pointed out. "Studies have shown that later school start times are better for adolescents," she said.

Not only do they start school early, but "they have long days. They have sports, after-school activities and studying, so there are things that are way beyond the family that put these teens at risk when it comes to driving," Winston said.

The report was published online May 20 in the journal JAMA Pediatrics.

To look at what role sleep plays in teen car crashes, a team led by Alexandra Martiniuk, an associate professor at the George Institute for Global Health in Sydney, collected data on more than 20,000 drivers aged 17 to 24.

The investigators found that those who said they slept six or fewer hours a night had a 21 percent higher risk of having a car accident than those who got more than six hours of sleep.

Moreover, those who got less sleep on the weekends had a 55 percent increased chance of having a single-car accident, where the car drifts or swerves off the road, they added.

Most accidents (86 percent) happened between 8 p.m. and 6 a.m., the researchers noted.

"Sleeping six hours a night is enough to put young drivers at significant risk of having a car crash. With work, study and social commitments, especially on weekends, it is easy to miss out on the extra hours of sleep we need," Martiniuk said in a statement.

More than 3,000 people die every day in car crashes around the world -- that's more than 1.3 million car-related deaths a year, with between 20 million and 50 million people injured or disabled, the researchers noted.

In the United States alone, it is estimated that 20 percent of all car crashes are the result of drowsy driving, which adds up to 1 million crashes, 50,000 injuries and 8,000 deaths a year, the study found.

More information

For more on teen driving, visit the Children's Hospital of Philadelphia.

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SUNDAY, May 19 (HealthDay News) -- Sleep apnea, the condition that robs sufferers of deep sleep by endlessly and subconsciously waking them up, becomes more common as people age. Now, a small new study raises the possibility that it may somehow cause -- or be caused by -- Alzheimer's disease.

Don't worry just yet if you have sleep apnea. The research is preliminary, and it's possible that there may be no connection between the two conditions. Still, scientists found that slimmer seniors with signs of disrupted breathing during sleep were more likely to have indicators of developing Alzheimer's disease.

"This is just a correlation," said study lead author Dr. Ricardo Osorio, a research assistant professor at the New York University School of Medicine, in New York City. But, he said, the prospect of a connection deserves further study since there may indeed be a link between sleep, aging and memory, which severely declines in Alzheimer's patients.

"It's clear that sleep is important for memory, and sleep changes as you get older," he said. "Disrupted breathing during sleep also increases with aging."

People who have sleep apnea often don't know it. They have trouble staying in deep sleep because their throats close as they slumber, temporarily blocking their airways and requiring them to subconsciously wake up to get air. Some sleep apnea sufferers may awaken 35 or more times an hour.

In the new study, researchers tested the sleep of 68 seniors in their 60s, 70s and 80s. Their average age was 71.

A quarter of them had symptoms of moderate to severe breathing problems during sleep (a sign that they may have sleep apnea), and about 49 percent had mild breathing problems. But none of them complained of sleepiness or concentration problems, which sleep apnea can cause, Osorio said.

The researchers discovered that thinner participants with breathing problems during sleep were more likely to have "biomarkers" -- biological signs -- of an increased likelihood of developing Alzheimer's. These signs indicate brain damage and decreased use of glucose (the sugar that blood transports) in the brain, Osorio said.

"We do not know if these people will develop Alzheimer's in the future, and we don't know how much risk they have," he said. "In the future, we might able to predict the risk."

Although excess weight raises the risk of sleep apnea, the obese participants with breathing problems didn't appear to have as much of an extra risk of Alzheimer's. There's another twist, Osorio said: For reasons that are unclear, being slightly overweight seemed to actually lower the risk of Alzheimer's.

So what's going on? The study doesn't give hints about which came first -- Alzheimer's or sleep breathing problems -- or whether something else, such as aging, might be causing both.

Another expert said it's clear that thinking skills may be impaired in patients with sleep disorders such as sleep apnea. "[But] the mechanisms of this are not well understood," said Dr. Brad Dickerson, an associate professor of neurology at Harvard Medical School in Boston.

As for the study, Dickerson said its findings are intriguing. However, he said, "these findings are very preliminary, and need to be further studied ... in order to make sure they are consistent and to better understand their implications."

The next step, Osorio said, is to launch a study of older people with sleep breathing problems and monitor them over time to see if they're less likely to develop Alzheimer's after getting treatment to improve their breathing.

The study is scheduled to be presented Sunday at an American Thoracic Society conference in Philadelphia. Findings presented at medical meetings typically are considered preliminary until published in a peer-reviewed journal.

More information

For more about Alzheimer's disease, try the U.S. National Library of Medicine.

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SATURDAY, May 18 (HealthDay News) -- Vitamin D supplements may help those with Crohn's disease overcome the fatigue and decreased muscle strength associated with the inflammatory bowel disease, according to new research.

Extra vitamin D "was associated with significantly less physical, emotional and general fatigue, greater quality of life and the ability to perform activities of daily living," said Tara Raftery, a research dietitian and doctoral candidate at Trinity College Dublin. She is scheduled to present the findings Saturday at the Digestive Disease Week meeting in Orlando, Fla.

Raftery and her colleagues evaluated 27 patients who had Crohn's in remission. (Even in remission, fatigue and quality of life can be problematic.) The patients were assigned to take either 2,000 IUs (international units) of vitamin D a day or a dummy vitamin for three months.

Before and after the study, the researchers measured hand-grip strength, fatigue, quality of life and blood levels of vitamin D.

"Hand-grip strength is a proxy measure of muscle function," Raftery said. "Muscle function has been known to be reduced in Crohn's disease."

Besides boosting bone growth and remodeling, vitamin D is thought to improve neuromuscular and immune function, reduce inflammation and help with other bodily tasks. Children and adults aged 1 year to 70 are advised to get 600 IUs a day; older adults, 800, according to the U.S. National Institutes of Health (NIH).

Vitamin D is found in fatty fish such as salmon, in smaller amounts in cheese, egg yolks and beef liver, and in fortified foods such as milk.

Sometimes called the sunshine vitamin, vitamin D is also produced when the sun's rays strike the skin.

Crohn's can affect any part of the gastrointestinal tract, but most commonly affects the end of the small bowel and the beginning of the colon. Symptoms vary, but may include persistent diarrhea, rectal bleeding, abdominal cramps, and pain and constipation. About 700,000 Americans are affected, according to the Crohn's & Colitis Foundation of America.

Its cause is not well understood, but Crohn's is thought to involve heredity and environmental factors. Experts believe that in those with Crohn's, the immune system attacks harmless intestinal bacteria, triggering chronic inflammation and, eventually, the disease symptoms.

The daily vitamin D supplement benefitted participants in many ways, Raftery found. "When levels of vitamin D peaked at 30 ng/mL (75 nmol/L) or more [a level considered healthy], muscle function in both the dominant and non-dominant hands were significantly higher than in those who had levels less than 30 ng/mL," she said.

Quality of life improved more for the D-supplement group, too. Using a standard measure to evaluate quality of life, the researchers found those who achieved a healthy blood level of the vitamin scored 24 points higher than those not on supplements. A 20-point difference is considered meaningful from a "real-world" perspective, Raftery said.

Raftery now is testing vitamin D in a larger, year-long study of 130 Crohn's patients.

The study results echo those of other researchers, including John White, professor of physiology at McGill University, Montreal. He said the research findings "show collectively that vitamin D acts in the intestine to stimulate the innate immune system to defend against pathogenic bacteria, and to enhance the barrier function of the intestinal epithelium [the lining of the intestine]."

Other researchers, including Raftery, have also shown vitamin D can help improve muscle strength, he said.

Vitamin D is getting a lot of attention in inflammatory bowel disease treatments, said Dr. Neera Gupta, co-chair of the Crohn's & Colitis Foundation of America's pediatric affairs committee.

More study is needed to determine the benefits of maintaining vitamin D levels higher than currently recommended, she said.

Gupta cautioned those with Crohn's not to self-dose with vitamin D. "Discuss your vitamin D status with your primary gastroenterologist to determine whether or not vitamin D supplementation is indicated in your particular situation," she said.

White said supplements are inexpensive and safer than too much sun exposure. A daily intake of 2,000 IUs is considered safe, he said. The safe upper limit for adults is 4,000 IUs, according to the NIH.

The data and conclusions of research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

To learn more about vitamin D, visit the U.S. National Institutes of Health.

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WEDNESDAY, May 15 (HealthDay News) -- The U.S. Food and Drug Administration has approved new, lower-dose labeling for the popular sleep drug Ambien (zolpidem) in an effort to cut down on daytime drowsiness that could be a hazard while performing certain tasks such as driving.

The move follows the FDA's request to manufacturers in January that drugs containing zolpidem carry instructions that lower the recommended dose and provide more safety information to patients.

"FDA has approved these changes because of the known risk of next-morning impairment with these drugs," the agency said in a statement released Tuesday on its website.

Sleep medications containing zolpidem include Ambien, Ambien CR, Edluar and Zolpimist, as well as generic versions of Ambien and Ambien CR.

"The purpose of the lowering is to help decrease the risk of next-morning impairment of activities that require alertness," Dr. Ellis Unger, director of the Office of Drug Evaluation I at the FDA's Center for Drug Evaluation and Research, said at the time of the agency's request to manufacturers. "We're particularly concerned about driving. A large fraction of the population drives and driving is an inherently dangerous activity."

Lowering the nighttime dose means there will be less residual drug in the blood by the time the person wakes up. Extended-release forms of the drugs tend to stay in the body longer, the FDA said.

The FDA has told manufacturers that recommended doses for women should be cut in half, from 10 milligrams to 5 milligrams for immediate-release products (Ambien, Edluar and Zolpimist) and from 12.5 mg to 6.25 mg for extended-release products (Ambien CR).

For men, the agency has asked manufacturers to change the labeling to recommend that doctors and other health-care professionals consider prescribing lower doses, meaning 5 mg for immediate-release products and 6.25 mg for extended-release products.

In explaining the different recommendations for men and women, Unger said that "women appear to be more susceptible to risk for next-morning impairment because they eliminate zolpidem from their bodies more slowly."

It's not clear why women eliminate the substance from their bodies more slowly than men.

Although there have been reports of adverse events, including motor vehicle accidents possibly related to zolpidem, the link has not and probably cannot be definitely established, Unger said.

The changes were spurred by new driving-simulation studies showing that currently prescribed levels of drugs containing zolpidem may be high enough to impair alertness the next day, he explained.

The FDA will be requiring driving-simulation studies for new sleep medications, and it is assessing other insomnia medications on the market. Eventually, Unger said, "we want driving data on all sleep medications."

Unger emphasized that next-day impairment is not limited to medications containing zolpidem but to all sleep medications.

"For all sleep medications, doctors should prescribe and patients should take the lowest dose," he said.

People taking any kind of sleep medication should not change their dose without first talking to their health-care professional, he stressed.

More information

Visit the U.S. Food and Drug Administration for more about next-morning impairment from sleep aids.

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TUESDAY, May 7 (HealthDay News) -- If you're a man suffering from low energy or libido, the drug industry is eager to help. So-called "Low T" -- low testosterone -- has become a common catch phrase in TV commercials, and sales of testosterone supplements are on the rise in the United States.

But a new study suggests that many clinics aren't disclosing the risks of testosterone treatment on their websites.

Researchers found that fewer than a third of 70 clinic websites mentioned the side effects of testosterone, although almost all touted potential benefits of treatment like improved sex drive and greater energy. Twenty-one percent, meanwhile, incorrectly denied that hormone treatment is linked to significant side effects.

Study co-author Dr. Kevin McVary, chairman of urology at Southern Illinois University School of Medicine, criticized the clinics that failed to be open about the risks of testosterone treatment. "It's unprofessional, and it reeks of snake oil," he said. "People should beware of using the Internet for medical advice regarding testosterone."

Testosterone, which is mainly produced in the testicles, is considered the male hormone (although it does occur in smaller quantities in women). Testosterone levels dip as men grow older. According to the Urology Care Foundation, researchers have found that about 20 percent of men over the age of 60 have low testosterone, which can lead to low libido, weak erections and fatigue.

Testosterone supplements are now available in a variety of forms, including injections, patches and gels that patients rub into the skin. The cost can run from $75 to $300 a month, said Dr. John Amory, a professor of medicine at the University of Washington in Seattle.

While testosterone treatment can indeed be beneficial, the side effects can include lower levels of healthy HDL cholesterol, increased male pattern baldness and possible harm to prostate health, Amory said.

Oral testosterone can lead to liver problems, study co-author McVary said, and testosterone overuse -- such as by some bodybuilders -- can lead to rage, acne, congestive heart failure and worsening of urinary symptoms.

In the new study, the researchers looked at the websites of 70 providers of testosterone supplements in Chicago, Houston, Los Angeles, New York City and Philadelphia. One-third were run by people who weren't physicians.

Only 27 percent described side effects of testosterone supplements, while 95 percent touted benefits. About a third of the sites run by urologists or endocrinologists described male breast growth as a potential risk. Seven percent of all the sites, however, denied breast growth as a potential side effect.

Amory said the new research appears to be valid and reflects "my impression of the way in which this [testosterone] is being oversold to patients."

McVary and Amory said they don't know if the clinics are acting legally when they omit information about testosterone risks. However, the U.S. Food and Drug Administration requires drug companies to describe the risks of prescription medications in their ads.

What to do? When it comes to medical information on the Internet, McVary said, "only go to legitimate sites that are sponsored by a medical organization that is known to you."

The findings were scheduled to be released Tuesday at the American Urological Association annual meeting in San Diego. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

For more about testosterone, try the U.S. National Library of Medicine.

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TUESDAY, May 7 (HealthDay News) -- Sleep problems may increase men's risk for prostate cancer, a new study suggests.

"Prostate cancer is one of the leading public health concerns for men, and sleep problems are quite common," said study author Dr. Lara Sigurdardottir, of the University of Iceland in Reykjavik. "If our results are confirmed with further studies, sleep may become a potential target for intervention to reduce the risk for prostate cancer."

Her study included about 2,100 men, aged 67 to 96, in Iceland. They were asked if they took medications to help them sleep, had trouble falling asleep or woke up during nights or early in the morning and had difficulty going back to sleep.

The researchers found that 14.4 percent of the men had severe or very severe sleep problems.

None of the men had prostate cancer at the start of the study. During five years of follow-up, 6.4 percent were diagnosed with prostate cancer, according to the study, which was published May 7 in the journal Cancer Epidemiology, Biomarkers & Prevention.

After adjusting for age, the researchers concluded that men with sleep problems were 1.6 to 2.1 times more likely to develop prostate cancer than those without sleep problems. Risk increased with the severity of sleeping problems.

The association was stronger for advanced prostate cancer than for overall prostate cancer. Those with very severe sleep problems had a more than threefold increased risk of advanced prostate cancer, the researchers found.

"Sleep problems are very common in modern society and can have adverse health consequences," Sigurdardottir said in a journal news release. "Women with sleep disruption have consistently been reported to be at an increased risk for breast cancer, but less is known about the potential role of sleep problems in prostate cancer."

She said these findings need to be confirmed in a larger and longer study.

Although the study found a potential association between sleep problems and prostate cancer, it did not prove a cause-and-effect relationship.

More information

The American Cancer Society has more about prostate cancer.

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WEDNESDAY, May 1 (HealthDay News) -- Extreme fatigue is common in U.S. teens and often goes untreated, a new study finds.

Researchers surveyed more than 10,000 teens, aged 13 to 18, and found that 3 percent reported having extreme fatigue that had lasted at least three months and was not relieved by rest. Half of the teens with extreme fatigue also had depression or an anxiety disorder.

More than half of those with long-term fatigue said they experienced severe or very severe problems in school, family or social situations, according to the study, which was published in the May issue of the American Journal of Psychiatry.

Only 14 percent of teens with long-term fatigue alone received any type of treatment for emotional or behavioral symptoms in the previous year, the survey found. Those with depression or an anxiety disorder in addition to long-term fatigue were more likely to have received care than those with fatigue only or with depression or an anxiety disorder only.

There are two key points to be taken from this study, said researcher Kathleen Merikangas, of the U.S. National Institute of Mental Health.

"Extreme fatigue that continues even after rest and interferes with adolescents' ability to participate academically, socially or at home is a pathological condition, yet it's not being recognized and treated," Merikangas said in a journal news release. "Also, teens with a depressive or anxiety disorder plus persistent fatigue appear to be sicker than those without fatigue."

More information

The MedlinePlus Medical Encyclopedia has more about fatigue.

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WEDNESDAY, May 1 (HealthDay News) -- There has been a dramatic increase in the number of emergency-room visits related to sleep medications such as Ambien, according to a new U.S. study.

Adverse reactions to zolpidem -- the active ingredient in the sleep aids Ambien, Ambien CR, Edluar and Zolpimist -- rose almost 220 percent between 2005 and 2010, researchers from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) found.

The study authors concluded that use of these drugs for the short-term treatment of insomnia should be carefully monitored. Zolpidem, which has been approved by the U.S. Food and Drug Administration, has been used safely and effectively by millions of Americans, but adverse reactions to the medication have increased. Most of these cases involved people aged 45 and older, the researchers said.

"Although short-term sleeping medications can help patients, it is exceedingly important that they be carefully used and monitored," SAMHSA administrator Pamela Hyde said in an agency news release. "Physicians and patients need to be aware of the potential adverse reactions associated with any medication, and work closely together to prevent or quickly address any problems that may arise."

Possible adverse reactions from medications containing zolpidem include:

• Daytime drowsiness
• Dizziness
• Hallucinations
• Agitation
• Sleep-walking
• Drowsiness while driving

After analyzing findings from a public health surveillance system that monitors drug-related illnesses and deaths, the researchers found that emergency-room cases involving medications such as Ambien increased sharply from about 6,000 in 2005 to more than 19,000 in 2010.

Women were more often affected than men. The findings revealed that during the study time frame, there was a 274 percent increase in the number of women who went to the emergency room due to a reaction involving zolpidem, compared to a 144 percent increase among men. In 2010 alone, women accounted for 68 percent of all trips to the emergency room for an adverse reaction related to zolpidem, the researchers said.

The study authors also noted that adverse reactions to these sleep aids could be worsened when the medication is taken with other substances, such as certain anti-anxiety drugs and narcotic pain relievers.

The SAMHSA report said that in 2010, half of all emergency-room visits related to zolpidem involved its interaction with other drugs. Moreover, 37 percent of all emergency visits resulted from the combination of these sleep aids and drugs that depress the central nervous system.

In response to the increase in adverse reactions, in January 2013 the FDA required drug manufacturers to cut the recommended dose for women in half. The FDA also recommended that drug companies reduce the dosage for men.

More information

The U.S. National Institutes of Health has more about zolpidem.

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MONDAY, April 22 (HealthDay News) -- Alternative treatments like transcendental meditation, biofeedback and guided breathing appear to reduce high blood pressure in some people, a new report suggests.

But only one method that does not involve medication -- aerobic exercise -- is both proven to have a major impact and highly recommended.

The report, by the American Heart Association, also says research doesn't support a reduction in high blood pressure from other relaxation and meditation techniques, yoga or acupuncture. However, the quality of research into these strategies is limited, the report adds, suggesting that there's still hope they have an effect.

"In general, there's a surprising level of evidence supporting some of the alternative techniques being effective, and surprisingly little or conflicting evidence in regard to other techniques," said Dr. Robert Brook, an associate professor of medicine at the University of Michigan. "These alternative techniques are a neglected stepchild and often not given nearly as much attention or funding for research, and are often not taken as seriously as other approaches."

Two things are clear, he said: The alternative approaches don't appear to be harmful, and they shouldn't be used instead of following a doctor's advice regarding medication.

The American Heart Association launched its report to give guidance to doctors and patients about treatments for high blood pressure, Brook said. "Traditionally, we'll talk about weight loss, diet, salt restriction and exercise. They're difficult to comply with, and people don't follow them. We decided it was time to review all of the research into alternative ways to lower blood pressure."

The report ranks aerobic exercise, like brisk walking, as having the greatest effect on high blood pressure and the highest quality research to support it.

Biofeedback, weight lifting, transcendental meditation and synchronized breathing (such as breathing to a series of tones) also scored well in terms of effectiveness.

When they're effective, the techniques may reduce the systolic number in a high blood pressure reading -- the top number -- by a modest 5 to 10 millimeters of mercury (mmHg), Brook said. A reading of 140 or higher is a sign of potential trouble.

How do the strategies work to reduce blood pressure? It's not clear in some cases, he said, although exercise appears to boost the functioning of blood vessels by widening them.

Samuel Sears, director of health psychology programs at East Carolina University, in Greenville, N.C., said the report is important but its focus misses the "mental benefits" of alternative treatments. "Patients seek and may gain broader benefits from some of these therapies, such as psychological and perceived control of their condition," he said.

So, should you try these strategies?

Dr. Kirsten Bibbins-Domingo, an associate professor of medicine at the University of California, San Francisco, said they're generally considered safe. However, "the inappropriate reliance on these approaches could result in delays in seeking medical treatment of hypertension," she said. "And many of these interventions are associated with out-of-pocket costs for patients, which is an additional consideration particularly if such interventions are ultimately shown not to be effective."

The report appears April 22 in the journal Hypertension.

More information

For more about high blood pressure, try the U.S. National Library of Medicine.

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The Nemours Foundation offers these potential causes for childhood insomnia:

• Being afraid of the dark.
• Having nightmares or bad dreams.
• Feeling stressed out or anxious about school or home life.
• Going through a major change in life, such as parents getting a divorce, moving, an illness or a death in the family.
• Being uncomfortable in some way, such as being too hot or too cold, hungry or too crowded in bed.

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SATURDAY, APRIL 13 (HealthDay News) -- For menopausal women who can't make it to the gym, higher levels of routine physical activity during the day may help relieve sleep problems caused by hot flashes or night sweats, a small new study suggests.

Exercise improves sleep for people in general, but studies in menopausal women have been inconclusive, said the researchers at the Pittsburgh site of the Study of Women's Health Across the Nation.

Their new study included 27 white and 25 black women, aged 54 to 63, with hot flashes and night sweats. The women kept sleep diaries and wore sleep monitors. They also provided information about their physical activity levels, including routine household and caregiving chores requiring light, moderate or vigorous effort, as well as sports and exercise in their leisure time.

The investigators found that women with higher levels of daytime activity reported fewer nighttime awakenings and better sleep. These benefits were mainly associated with household and caregiving chores, rather than sports or exercise, the study authors noted in a news release from the North American Menopause Society.

The positive effects of physical activity occurred mainly in white women who were not obese. Further research is needed to find out why black and obese women may not get the same sleep benefits from physical activity, the researchers said.

The study, by Maya Lambiase and Rebecca Thurston, was released online recently in the journal Menopause in advance of publication in the September print issue of the journal.

More information

The U.S. Office on Women's Health has more about menopause.

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FRIDAY, April 12 (HealthDay News) -- Drivers with the sleep disorder sleep apnea are more likely to nod off at the wheel and fail simulated driving tests than motorists without the condition, new research finds.

Scientists from the University Hospital in Leeds, England, conducted two studies involving sleep apnea -- a pattern of disrupted breathing during sleep -- and driving performance.

In one study, they tested the driving ability of 133 patients with untreated sleep apnea and 89 people without the condition using a simulated driving test. As they navigated the roughly 56-mile course, the "drivers" were assessed on completion, time spent in the middle lane, unprovoked crashes and crashes caused by veering off the road.

Twice as many people with untreated sleep apnea (24 percent) failed the driving test, compared to 12 percent of those who didn't have the condition. The researchers noted many of the sleep apnea patients couldn't complete the test. They also had more crashes and had difficulty following a clear set of directions given at the start of the test.

"Driving simulators can be a good way of checking the effects that a condition like sleep apnea can have on driving ability," said the study's chief investigator, Dr. Mark Elliott, in a news release from the European Lung Foundation. "Our research suggests that people with the condition are more likely to fail the test."

The study is scheduled for presentation Friday at a meeting of the European Respiratory Society and the European Sleep Research in Berlin.

In another study, 118 people with untreated sleep apnea completed a survey about their driving behavior and also took the simulated driving test. Their results were compared to those of 69 people who didn't have sleep apnea.

More than one-third (35 percent) of those with sleep apnea admitted to nodding off while driving. The researchers noted 38 percent of this group also failed the driving test. In contrast, only 11 percent of those without sleep apnea admitted falling asleep while driving. And none of the motorists without sleep apnea failed the driving test.

Both studies highlight the dangers of untreated sleep apnea and driving, Dan Smyth, of Sleep Apnea Europe, said in the news release. "These studies give weight to the need for provision of sufficient resources for early diagnosis and treatment of sleep apnea, where effective treatment ensures a return to acceptable risk levels for road users."

Interrupted sleep at night leads to daytime fatigue, and sleep apnea has previously been linked to increased risk for car crashes. People with the condition are also at greater risk for medical conditions such as high blood pressure.

Data and conclusions presented at meetings typically are considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Heart, Lung, and Blood Institute provides more information on sleep apnea.

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THURSDAY, April 11 (HealthDay News) -- Treating sleep apnea, a common sleep disorder, boosts people's productivity at work, according to a new study.

Sleep apnea interrupts breathing during sleep, causing people with the condition to wake up throughout the night. Previous research has shown that people with sleep apnea are less productive at work, usually because of excessive daytime sleepiness.

The new study looked at whether using continuous positive airway pressure (CPAP) during sleep improved the participants' productivity. With CPAP, a patient wears a mask connected to a machine that sends pressurized air into the throat to keep the airway open throughout the night.

The study included 45 people, aged 40 to 56, with sleep apnea who completed questionnaires before and after three months of CPAP treatment.

The 35 patients who closely followed the treatment program had significant improvements in their daytime sleepiness levels and in their work productivity, but this was not the case for the 10 patients who did not follow the treatment program, the investigators found.

The study was scheduled for presentation Thursday at a meeting of the European Respiratory Society and the European Sleep Research Society in Berlin, Germany.

"Continuous positive airway pressure is the gold standard treatment for moderate-to-severe obstructive sleep apnea," study lead author Dr. Evangelia Nena said in a European Lung Foundation news release. "Previous research has shown the potential benefits of CPAP to patients' health and quality of life, and our findings add to this body of evidence, demonstrating the advantages the treatment can have on productivity at work."

Data and conclusions of research presented at meetings typically are considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Heart, Lung, and Blood Institute has more about sleep apnea.

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THURSDAY, April 11 (HealthDay News) -- Playing a certain type of sound stimulation during sleep might help improve your memory, a small new study suggests.

Slow oscillations in brain activity occur during slow-wave sleep and are critical for retaining memories. This study found that playing sounds synchronized to the rhythm of those oscillations enhances the oscillations and boosts memory.

The findings suggest an easy and noninvasive way to enhance memory, according to the authors of the study, which was published online April 11 in the journal Neuron.

"The beauty lies in the simplicity to apply auditory stimulation at low intensities -- an approach that is both practical and ethical, if compared, for example, with electrical stimulation -- and therefore portrays a straightforward tool for clinical settings to enhance sleep rhythms," Dr. Jan Born, of the University of Tubingen, in Germany, said in a journal news release.

Born and his colleagues conducted their tests on 11 people while they slept on different nights. When exposed to stimulating sounds that were in sync with the brain's slow oscillation rhythm, the participants were better able to remember word associations they had learned the evening before.

Sound stimulation out of sync with the brain's slow oscillation rhythm was ineffective in improving memory.

The researchers said the sound stimulation technique might also help improve sleep.

More information

The U.S. National Institutes of Health explains how sleep strengthens memories.

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The U.S. Kidney and Urologic Diseases Information Clearinghouse lists these suggestions for parents to help prevent bedwetting in children:

• Encourage your child to drink plenty of fluids during the day, to avoid drinking too much at bedtime.
• Don't give your child caffeinated drinks such as soda or tea.
• Let your child have one drink with dinner, but make that the last drink before bed.
• Make sure your child goes to the bathroom right before bed.
• Be supportive and don't scold your child if he or she wets the bed.
• Offer plenty of praise when your child stays dry all night.

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WEDNESDAY, April 3 (HealthDay News) -- A new class of sleep medications appears to help people fall asleep without causing grogginess the next day, researchers say.

These new medications -- known as dual orexin receptor antagonists (DORA) -- target a more specific region of the brain than popular sleep drugs such as Ambien and Lunesta, promoting sleep without affecting learning and memory (also called "cognition"), according to the new research.

"We've shown that these compounds improve sleep at doses that don't impact cognition," said Jason Uslaner, lead author of a study published in the April 3 issue of Science Translational Medicine. Uslaner is director of In Vivo Pharmacology at Merck & Co., which funded the study.

Merck already has one such drug, suvorexant, under review by the U.S. Food and Drug Administration (FDA).

More than 30 million Americans struggle to get a good night's sleep, and about one-third of these use drugs to help the process, the study authors pointed out.

But widely prescribed sleep medications such as Ambien (zolpidem) and Lunesta (eszopiclone) can leave people feeling hung over and inattentive the next day. So much so that the FDA recently cut recommended doses of Ambien and other drugs that contain zolpidem for fear that their use, even the night before, might impair driving or other activities the next day.

Lunesta and Ambien affect GABA receptors, which are found throughout the brain and are associated with side effects, including thinking disturbances, and deficits in attention and memory, explained Uslaner.

About 15 years ago, scientists discovered chemical messengers known as orexins, which are released by a relatively small brain region known as the lateral hypothalamus. This area of the brain releases orexins during the day to keep us awake and lowers levels at night so we can sleep.

The appeal of orexin antagonists, said Dr. Michael Thorpy, director of the Sleep-Wake Disorders Center at Montefiore Medical Center in New York City, is that they "target a system that's more specific for sleep."

That means, theoretically, fewer side effects and perhaps less of a tendency to be habit forming, Thorpy explained.

Uslaner and his colleagues investigated a compound called DORA-22, which has the same mechanism of action as suvorexant, to see how it fared alongside not only Ambien and Lunesta but also diazepam (Valium) in rats and rhesus monkeys.

DORA-22 did not lead to the same mental impairments as the other three drugs. Rhesus monkeys and rats performed just as well on memory and attention tasks shortly after being administered DORA-22 as they did on an inactive placebo.

In each case, the minimum dose to achieve sleep was compared with the minimum dose that altered memory and thinking. DORA-22 promoted sleep at lower doses than those that impaired mental skills when compared with the "control" drugs.

This is the first time in years that scientists have targeted a totally different receptor in the quest to combat insomnia, said Dr. Alexandre Abreu, co-director of the UHealth Sleep Center at the University of Miami Miller School of Medicine.

But many questions remain: Do the drugs truly have fewer side effects? Will they be habit forming? And will they change the quality of sleep in any way?

Those questions will only be answered with more testing and use in humans, he said.

Experts note that findings from animal studies do not always hold up in human trials.

More information

The U.S. National Institutes of Health has more on insomnia.

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The Women's Heart Foundation explains how sleep disturbances may affect heart health:

• Increased stress.
• Increased hunger, resulting weight gain.
• Increased risk of stroke, as a possible result of sleep apnea.
• Increased risk of heart disease, as a possible result of sleep apnea.
• High blood pressure, faster heart rate and irregular heartbeat.

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